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Discussion

Retained placenta?

Ok so had a mom which had trouble with her placenta detaching after birth. The midwive pulled a bit and finally was able to get it out. But they felt there was some tissue left behind. When the CNM called the MD who covers her, he said to give toradol, methergine and do fundal massage. She was not bleeding abnormally...but she was having severe abdominal pain. I don't think the doc felt like coming in to do the D&C...have you Ever heard of such an order??

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    Haven't seen enough retained placentas to say that I have heard of that order; however I've been told to give Demerol and stand by...30 min later the MD was elbow deep removing bits of placenta!

    Posting from my phone, ease forgive my fat thumbs! :)

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    Did they U/S it? At my facility, if there is concern about retained placenta (whether an OB or CNM patient) the resident and/or fellow will come in with an U/S and scan the woman's abdomen to look for retained placenta. If they see anything, or if she's bleeding severely, they will take her back to the OR for a D&C.

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    Well no they didn't do an US. That's what seems so weird to me. They were going to just wait until the MD could come in...crazy. She was not bleeding. But the risk of infection really takes off with those bits sitting in there!

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    Did they U/S it? At my facility, if there is concern about retained placenta (whether an OB or CNM patient) the resident and/or fellow will come in with an U/S and scan the woman's abdomen to look for retained placenta. If they see anything, or if she's bleeding severely, they will take her back to the OR for a D&C.

    That is exactly what the residents/attendings do at my facility.

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    What...give Methergine??

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    Opps sorry. Yes I'm use to working with residents who deal with problems immediately...US and D&E..

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